Birth Control for Overweight Women

There are several factors that can compromise the effectiveness of your birth control. One of these is weight. Being overweight or obese can affect the absorption and metabolism of drugs and hormones.

There are concerns that obesity could undermine the protective benefit of certain hormonal contraceptives including ​the pill, Nexplanon, shots, and the patch. While it is reassuring that reviews of studies have not found significant effects other than with the patch, these reviews also note that there are few high-quality studies. To ensure your birth control method is as effective as possible, there are a few things that you can do

Intrauterine Devices (IUDs)

closeup of an IUD

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Intrauterine devices (IUDs) such as ParaGard copper IUD and levonorgestrel-releasing IUDs are a very effective means of birth control in overweight women. However, there may be a higher risk of the IUD falling out if your BMI is 40 or higher.

Sometimes there may be problems with insertion of the device. If you are obese, it can sometimes be difficult to locate the cervix or determine the size and direction of your uterus. Your healthcare provider can usually overcome this by using an ultrasound and other special equipment to help guide the IUD insertion.

Research suggests that IUDs may be the safest and most effective means of birth control for obese women. Hormonal IUDs may also help reduce the risk of endometrial cancer and hyperplasia, conditions to which obese women are more vulnerable.

Depo-subQ Provera 104

Depo subQ Provera closeup

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There is a newer version of the original Depo Provera shot known as Depo-subQ Provera 104. This non-permanent form of birth control has 31% less hormone that the previous version and, as a result, a lower incidence of adverse side effects.

It newer version is injected beneath the skin as opposed to in the muscle. Shots are delivered quarterly, or every 12 to 14 weeks.

Depo-subQ Provera 104 was shown to be effective in obese women in two different studies. However, the one major downside is that the drug is known to cause weight gain, a major consideration if you are already struggling with weight control.

Another consideration is that it can take an average of nine and 10 months to fully restore fertility once treatment is stopped. In heavier women, it may take even longer.

The traditional version of the Depo Provera shot can also be used for obese women.

Barrier Birth Control Methods

diaphragm and spermicidal jelly

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A barrier birth control method is a device that physically blocks sperm from entering the opening of the uterus. These contraceptives tend to be less effective than IUDs or hormonal methods, so they need to be used correctly to provide the best protection. Failure is most often associated with improper or inconsistent use rather than a problem with the product itself.

Barrier birth control options include male condoms, female condoms, spermicides, the sponge, diaphragms, and the cervical cap.

You can further increase the effectiveness by using a double barrier method, such using a condom with a spermicide or a diaphragm with a condom. If uncertain how to use a product, speak with your healthcare provider or ask your pharmacist.

Tubal Ligation

USA, New Jersey, Jersey City, Check up visit in doctor's office
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Tubal ligation is a permanent method of birth control. Often referred to as "having your tubes tied," it is a surgical procedure designed to close off the fallopian tubes. Once the procedure is performed, it is highly unlikely that the sperm will be able to reach the egg, It is one of several surgical sterilization techniques.

While there is no evidence that your weight will compromise the effectiveness of a tubal ligation, the surgery itself is often more difficult to perform. In this population of women, the surgery might take slightly longer and require more anesthesia.

Tubal sterilization surgeries are often done laparoscopically. Compared to open surgery, laparoscopic surgery is associated with less risk such as infection in obese women.

7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. Lopez LM, Bernholc A, Chen M, Grey TW, Otterness C, Westhoff C, Edelman A, Helmerhorst FM. Hormonal contraceptives for contraception in overweight or obese women. Cochrane Database Syst Rev. 2016 Aug 18;(8):CD008452. doi:10.1002/14651858.CD008452.pub4

  3. Reifsnider E, Mendias N, Davila Y, Bever Babendure J. Contraception and the obese womanJ Am Assoc Nurse Pract. 2013;25(5):223–233. doi:10.1111/1745-7599.12011

  4. Schneider ME. Beware hormonal IUD expulsion in obese women. MdEdge 2017.

  5. American Cancer Society. Endometrial cancer risk factors.

  6. Batur P. Female contraception. Cleveland Clinic.

  7. Shabanzadeh DM, Sørensen LT. Laparoscopic surgery compared with open surgery decreases surgical site infection in obese patients: a systematic review and meta-analysis. Ann Surg. 2012 Dec;256(6):934-45. doi:10.1097/SLA.0b013e318269a46b

By Dawn Stacey, PhD, LMHC
Dawn Stacey, PhD, LMHC, is a published author, college professor, and mental health consultant with over 15 years of counseling experience.